05.10.2011 | Autor: admin
Dr. PHIL C. BOYLE, Family Physician, Galway, Ireland.
INTRODUCTION
Infertility is a significant problem for many couples in the developed world today. Up to 1 in 5
couples experience difficulty conceiving in the United States 1 . In Europe 1 in 6 couples have
difficulty conceiving. Current infertility protocols usually advise blood tests on day 3 to 7 of
the menstrual cycle to assess gonadotrophin and prolactin levels, thyroid function, hemoglobin,
rubella status and testosterone levels – if clinically indicated. In addition bloods tests are
usually taken on day 21 or 22 of the cycle to measure progesterone levels in the probable mid
luteal phase of the menstrual cycle. Most specialists would agree that ovulation is probably
occurring if progesterone levels exceed 30 nmol/l (9.5 ng/dl). After a seminal fluid analysis,
postcoital test, ultrasound examination, laparoscopy and dye test and possibly a six to nine
month trial of clomid those couples who have not conceived face the prospect of Artificial
Reproductive Technology (ART) if they wish to continue fertility treatment. Occasionally
ovulation induction with FSH (with or without intrauterine insemination) may be given for a
further 3 to 6 cycles before embarking upon In Vitro Fertilization (IVF) or Intracytoplasmic
Sperm Injection (ICSI), which we refer to as ART throughout this chapter.
Full text NaProTechnology (NPT) – After previously unsuccessful Artificial Reproductive Technology (ART)
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